On the heels of an Accreditation Canada survey, the Critical Care Unit at Thunder Bay Regional Health Sciences Centre (HSC) joined the Safer Healthcare Now! Delirium and Medication Reconciliation Collaborative, looking for ways to improve practices. The Accreditation Canada survey recognized the Critical Care Unit as an area of excellence in Medication Reconciliation, but this was a timely opportunity to fine-tune their processes and collaborate with like-minded people from across Canada to learn about the tools others were using. The SHN collaborative opened doors to connect with and be mentored by experts to get their advice on changing practice.
Lisa Beck, Director of the Trauma Program, Critical Care and Emergency Services, and Chad Johnson, Clinical Nurse Specialist, Trauma, Critical Care and Neurosurgical, were part of the Thunder Bay Regional HSC task force to develop Medication Reconciliation processes that could be implemented throughout the hospital’s critical care units. A solid process for Medication Reconciliation on admission has been implemented and the group is now refining the process upon transfer from critical care.
“Once we started instituting a Best Possible Mediation History (BPMH) process, we assumed there was a solid medication history-taking skill set, however we identified a knowledge gap with our staff,” says Lisa Beck. “Staff had become reliant on one person to do a thorough medication history and the concept of a BPMH was new to them. We had to re-educate staff on medication history-taking and teach them new concepts of BPMH and how it is a 24/7 process so that they are empowered to do a better job of getting medication information.”
“Medication Reconciliation varies from unit to unit,” says Chad Johnson. “What works on one unit may not work on another unit. You have to be open and tailor your processes to each individual area. Using audit tools and feedback you need to step back, look at your Medication Reconciliation processes and redevelop them, or tweak them a bit so that they will work. This is a lot of work and not easily achievable. We have made some great strides and are maintaining the momentum.”
Both Beck and Johnson say that the collaborative helped to get their work moving and they are now sharing their experiences with a Steering Committee working to implement Medication Reconciliation hospital-wide.
Watch www.saferhealthcarenow.ca for more articles on the Safer Healthcare Now! MedRec and Delirium Collaborative.
 Medication Reconciliation is a formal process in which healthcare providers work together with patients, families and care providers to ensure accurate and comprehensive medication information is communicated consistently across transitions of care. Medication Reconciliation requires a systematic and comprehensive review of all the medications a patient is taking to ensure that medications being added, changed or discontinued are carefully evaluated. It is a component of medication management that informs and enables prescribers to make the most appropriate prescribing decisions for the patient.